A 7-Step Plan for Implementing Rehab in 30 Days

By Jay Greenstein, DC, CCSP, CGFI-L1, CKTP

In today's age of an ever-growing body of knowledge on the treatment of neuromusculoskeletal conditions, as well as health care reform and pay-for-performance, our profession continues to evolve for the better. Because of improved outcomes, the current literature supports the use of active care, where patients play a critically important and active role in their treatment plan. As far back as 1995, Twomey et al., demonstrated the importance of exercise and mobility in the treatment of low back pain.1 Evans et al., found that manipulation and low-tech rehab was better than manipulation alone or manipulation and high-tech rehab for chronic neck pain patients.2 Although outcomes were closely matched, patient satisfaction was the highest in the manipulation and low-tech rehab group. In a second, two-year follow up study, Evans et al., also reported that spinal manipulation combined with exercise yielded better outcomes than manipulation alone for chronic neck pain.2 Bronfort et al., also reported similar results: exercise and manipulation combined are more effective than either one alone.3 Many doctors of chiropractic today are also treating a wide variety of extremity conditions, such as rotator-cuff disorders, lateral epicondylitis/osis, plantar fasciitis and many other musculoskeletal conditions that require rehabilitation.

After seeing and hearing all of your chiropractic friends adding tools to their clinical tool box, you say to yourself, "It's time to implement a rehab program into my practice." The next thing you say to yourself is, "Where do I begin?" Well, here is your roadmap; a tried and true way to add needed services to your practice so your patients can reap the clinical benefits and you can reap the professional rewards. If you work consistently towards your goal, in 30 days you'll have a revitalized practice.

Step 1: Overview

Sit down, preferably with your staff to improve "buy-in," and discuss what you want your new practice to look and feel like in 30 days. Why should you implement a rehab program into your office? What goals do you have specifically for this program and how will you and your team carry them out? What are the benefits to the patients, the practice and the staff? What are the potential challenges? How will you and your team overcome those challenges? What are the new job roles for you and your staff? What process and schedule changes will you need to make, if any? How will you market these new services to referral sources and patients? The question of your space requirements needs to be addressed as well. Once you have answered these basic questions, proceed to Step 2.

Step 2: Compliance

When implementing a rehab program into your practice, it's critical to understand all the safety, state board of examiners/licensure/scope of practice, and coding and documentation requirements that are needed. This is where many doctors fail. The right thing to do is to go to your state board of examiners and industry experts to ask the necessary questions. Make a small investment in time and money and get the right answers the first time. Many doctors consult with practice-management companies that tell them how to grow their practices. Just make sure that all the hard work you do to grow your practice doesn't go to paying your future legal bills because you took too many shortcuts and got into trouble. Compliance is the cornerstone to a great practice no matter what type you have.